Bridging Disciplinary Boundaries (January 11 - 14, 2007)



3P

Predictors of In-Home and Community Based Service Use among Asian American Elders

Duy D. Nguyen, MSW, Columbia University and Ada Mui, PhD, Columbia University.

By 2050 the Asian American population is projected to grow 213 percent to 33.4 million and represent about 8% of the total U.S. population (U.S. Census, 2004). Over the next 20 years, however, Asian American elders over 65 will increase by roughly 250%, more than double the rate of the projected population growth of non-Hispanic Black Americans and triple the rate of non-Hispanic White Americans (U.S. Census, 2002). These population trends underscore the need to shed light on the experiences of Asian adults to better understand the health needs of Asian elders.

Though the Asian American population is growing rapidly, little gerontological research has been conducted on Asian groups (LaVeist 1995; Tanjasiri, Wallace, & Shibata, 1995; Dilworth-Anderson et al., 2002; Ghosh, 2003). Although a range of health needs exist (Tanjasiri, Wallace, & Shibata, 1995), only a handful of studies have examined Asian elders' use of in-home and community-based services (Moon et al., 1998; Lai, 2001; Lee & Peng, 2001; Peng et al., 2003). Lacking empirical research limits the ability of social work practitioners and policymakers to respond to the changing population. The current study contributes much needed data on Asian elders' use of in-home and community-based services. An understanding of the factors predictive of service utilization will enable gerontologists to develop culturally appropriate practices and policies to meet the needs of Asian elders.

Using probability sampling methods, 407 Asian elders belonging to the six most populous Asian ethnic groups (Chinese, Filipino, Indian, Japanese, Korean, and Vietnamese) were included in the survey. Andersen's (1995) behavioral model, the most frequently used framework, was used to analyze the effects of predisposing, enabling, and need factors on service utilization.

Descriptive statistics reveal community-based service utilization differences among the six Asian ethnic groups. The community-based services included in the survey were: services from senior centers, clergy/religious, using transportation or legal services, attending citizenship or English classes, and receive support from a social worker. In-home services, either home care services or visiting nurse services, were used only by Chinese, Korean, and Japanese elders.

Using community-based services and in-home services as outcome variables, logistic regression models yielded statistically significant results. While much prior research has reported need factors are the most predictive of service utilization, the current study found that enabling factors carried the most weight in the statistical model for both in-home and community-based service utilization. Having Medicare coverage increased the likelihood of using community-based or in-home services.

The findings will enable gerontological researchers and service providers to respond to the needs of Asian elders through individual, family, and community interventions, as well as social policies that facilitate access to needed services.